How the NHS Works, part 3 (Referrals)
Referrals
If your GP feels that your ailment requires more expert care, you may need to see a specialist, called a Consultant. Your GP will then need to refer you to a hospital, where consultants are based. The old-fashioned way of doing this was for your GP to write a letter to the consultant and request an appointment. The patient then waited to receive an appointment letter from the consultant’s office. Things are changing so that some appointments may be booked online by the GP or the patient. Waiting times to see consultants vary according to region and speciality. Current government guidelines (targets) are that it should take no longer than 6 weeks weeks to see a consultant for an initial consultation. The initial appointment almost never involves treatment. Government guidelines state that you should wait no longer than a further 18 weeks for the next appointment, when treatment begins.
It is very important to understand that under the NHS you cannot refer yourself to a consultant. That means if you wish to see a dermatologist because you have a minor skin rash, you will have to first go to your GP, ask for their help, and if they feel your condition is minor or does not require a specialist, you will not be allowed to see a dermatologist. It’s that simple. The NHS functions as a government-run HMO (Health Maintenance Organization) in that respect. Care is controlled by your GP, who acts as gatekeeper.
As far as targets go, once you have seen a consultant for your initial consultation within 6 weeks, one of that department’s targets is considered to have been met. Once you have had your second appointment within the next 18 weeks, another target has been met. If you require further treatment after that second appointment, my experience at my local hospital has been that I am put to the back of the waiting list again, which has meant a further 18-week wait. For patients with chronic conditions, this is not a viable option, as illustrated by this article which appeared on BBC News.
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